{Reference Type}: Systematic Review
{Title}: Extensive Spinal Epidural Abscess: A Systematic Review of Risk Factors, Clinical Presentation, and Management with a Case Illustration.
{Author}: Hugues Dokponou YC;Ontsi Obame FL;Mohcine S;Saad ME;Abderrahmane H;Imbunhe N;Mandour C;Gazzaz M;
{Journal}: World Neurosurg
{Volume}: 189
{Issue}: 0
{Year}: 2024 Sep 19
{Factor}: 2.21
{DOI}: 10.1016/j.wneu.2024.06.073
{Abstract}: <B>BACKGROUND: </B>Extensive spinal epidural abscess (ESEA) is a rare clinical entity subject to delayed diagnosis, which can be explained by the extension of the epidural collection, thereby delaying the mass effect responsible for its clinical manifestations.<BR><B>METHODS: </B>We report a rare case of an extensive C7-T10 epidural abscess in a 54-year-old man treated with antibiotics, laminectomy, and abscess drainage. In addition, we conducted a systematic literature search according to the "Preferred Reporting Items for Systematic Reviews" guidelines. Relevant studies (1980-2023) reporting patients with ESEA were identified from PubMed databases.<BR><B>RESULTS: </B>A total of 48 studies reporting 55 patients were included in this study with a mean age of 55.7 ± 14.6 years with a male predominance of 61.8% (n = 34). The median duration of follow-up was 38 months (21.5-64.3). The mortality rate of ESEA was 1.8% for a 21.8% morbidity rate with 76.4% (n = 42) reported to have been improved after surgery.<BR><B>CONCLUSIONS: </B>Both single and multilevel laminectomy with abscess drainage for ESEA leads to patient recovery from this devastating condition. Evaluation of the outcome with data on time-to-Nadir and Nadir-to-surgery is needed to codify ESEA management.